Laserfiche WebLink
City of Santa Ana <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agreement and <br />amendments (if any) are no longer in effect. <br />Note: If your agreement is grant related, please ensure that all grant retention_ requirements <br />have been safisfied prior to signing the termination form. <br />Is the agreement(s) a permanent record? Yes No <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-1520 if you have any questions. <br />The agreement with <br />G <br />COTC Office Use Only <br />SGT 23 ac 3: 315 <br />No. N-2017-010 was completed on I i h-7 and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />pjz <br />Phone/Ext.: <br />))ii <br />5l�5T <br />Signature: <br />naQAIL ) C`U&n <br />Date: <br />i © 1A 1-7 <br />Revised: 10-18-16 <br />